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Background: Existing meta-analyses on the diagnostic test accuracy of depression screening tools have treated both clinician-administered semi-structured diagnostic interviews and lay-administered fully structured interviews as equivalent gold standards for assessing major depressive disorder (MDD) and combined accuracy results across interview types without adjustment. Fully structured interviews do not involve clinical judgement and are considered potentially more reliable but less valid than semi-structured interviews. No studies have assessed whether semi- and fully structured interviews differ in the likelihood that MDD will be diagnosed.

Objectives: To evaluate the association of interview method with odds of MDD diagnosis, controlling for depressive symptom scores and patient characteristics.

Conclusions: The likelihood of MDD diagnosis appears to depend on the diagnostic interview used to assess MDD. Meta-analyses on depression screening tool accuracy should consider methods to account for possible differential verification bias.